Claim for Injury Allowance and Notification of Work Injury (211)

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The work-injury allowance claim form is intended for an employee and a self-employed person who have been injured at work as a result of a work-related accident. The form is also intended for a volunteer who was injured during his or her volunteer activities. In this form you can also submit a request for recognition of an occupational disease or medical disability resulting from working conditions.
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